Best Investments, Best Returns: Improving Mental Health for College Students | We
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Best Investments, Best Returns: Improving Mental Health for College Students

Daniel Eisenberg

S. J. Axelrod Collegiate Professor of Health Management and Policy

Questions about public policy and social justice have always been top of mind for
Daniel Eisenberg, even as he completed his undergraduate work in economics. “I just
needed a lens with which to address the questions I had about public policy and social
policy. What should our society be investing in? Are we making good public policy
decisions? Economics is one of the main languages to analyze those kinds of questions,”
he says.

Eisenberg stayed with economics for his doctoral work at Stanford University, but
he continued looking for policy-related ways of applying that work. “I was always
interested in health and psychology and was drawn to public health because it is so
connected to real-world problems and also very holistic,” Eisenberg says. “That resonated
with my economics training and my passion for questions about human well-being.”

“Everything that matters for health matters for mental health.”

Landing on mental health within the field of public health also has an economics flavor
for Eisenberg, the S. J. Axelrod Collegiate Professor of Health Management and Policy
and a Research Professor at the Population Studies Center at the University of Michigan.
“Like so many others in public health, I want my research to help improve society
on a broad scale. Mental health is a big-picture issue that affects everybody in a
population, and mental health is tied into so many of our socioeconomic—and our biological—systems.
Basically, everything that matters for health matters for mental health,” he says.

Investing Well in Young People

As director of theHealthy Minds Network, Eisenberg has spent the last twelve years conducting and interpreting research on
adolescent and young-adult mental health. Since 2005, the Network has collected and
examined mental health, service utilization and related issues among undergraduate
and graduate students at over 250 colleges and universities with over 300,000 survey
respondents.

This incredible amount of data gives Eisenberg and his team a unique perspective on
youth mental health and the policy decisions we make that affect it. “We probably
aren't investing in all the right places,” Eisenberg assesses. “We’re probably not
doing enough prevention of mental health. Early childhood and even infant programs
with really good evidence of positive mental health impacts—first of all by improving
parenting and reducing abuse and neglect—are a place to invest more. There are also
important investments to make later in childhood, adolescence, and young adulthood.
If we invest in people when they’re young, decades later we will see the fruits of
those interventions.”

We clearly have more familiarity with and more openness to using mental health services,
and a lot of young people are benefiting from that.

In response to the broad concern about rising youth mental health conditions, Eisenberg
is cautiously optimistic. “The evidence is that they might be on the rise a bit. But
it’s much clearer from the data that use of mental health services has gone way up
among young people. That’s a good thing. People are getting more support. Ideally,
we would be preventing rather than treating after problems emerge. But we clearly
have more familiarity with and more openness to using mental health services, and
a lot of young people are benefiting from that.”

Common Struggles and Signs of Hope

Depression and anxiety are the most common types of mental health conditions among
young people. While clinically diagnosable eating disorders are less prevalent, Eisenberg
notes that concerns about eating and body image are common “If we refer broadly to
disordered eating and body image concerns, they are highly prevalent, especially among
girls but also among boys. We should keep in mind that severe psychological suffering
or distress can be experienced even when a situation doesn’t manifest itself in a
full-blown disorder.”

Extending awareness to all conditions that can affect mental is a foundation of Eisenberg’s
research. “Suicide, for example, is an important issue that does get a fair amount
of attention. But as important as suicide is—as an outcome that we want to reduce—it’s
a small part of the overall picture of youth mental health. Ideally, we'd be investing
in programs that prevent people from ever getting to the point of being at risk for
suicide,” he says.

Good Investing Is Proactive Investing

That overall picture of youth mental health that the Healthy Minds team has developed
is why Eisenberg is so passionate about population-level approaches to managing mental
health. “When you begin with regular, widespread screening to see where people are,
check symptom and risk levels they might have, then you can really see prevention
happening. But you have to be proactive—not wait for people to feel they might have
an issue before deciding to get screened,” he says.

For those whose screening results put them in middle ranges of mental health quality,
a less-intensive intervention—perhaps something online—would be provided. “We have
a growing set of online mental health resources and services,” says Eisenberg. “And
we have evidence that these can be helpful not only for people at clinical levels
but also for those who are at subclinical mental health levels. In those cases, a
less-intensive intervention can often prevent an issue from getting worse and can
set people on a path to getting better.”

Many campuses need to hire more mental health professionals, but they also need to
go beyond that as the only strategy.

Proactive interventions and digital interventions appeal to college students. “As
a population of young adults, they inherently understand the tech side of it and also
understand the gravity of caring for their own mental health,” Eisenberg says. “And
increasing demand for mental health services across nearly every organization and
group that provides such services is untenable. Many campuses need to hire more mental
health professionals, but they also need to go beyond that as the only strategy. The
key is to figure out how best to integrate technological approaches with in-person
connections and support.”

Eisenberg emphasizes that the proactive, population-wide, often-digital interventions
he researches do not replace in-person, individual therapy, especially for those with
clinical levels of a mental health. “But we do need to stem the tide,” he says. “And
we have tools to build complementary approaches that cost a lot less and help us keep
up with the demands of individual therapy.”

Eisenberg sees public health as a leader in improving mental health for entire populations:
“This intersection of public health and mental health is so full of possibilities,
and the data continues to back up our optimism. It’s a privilege to be in an area
that’s so broadly relevant in populations and cross-cutting across perspectives and
disciplines.”